Provider Demographics
NPI:1699840215
Name:EXCEL TRANSPORTATION, INC.
Entity Type:Organization
Organization Name:EXCEL TRANSPORTATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKHAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KAGANOVSKIY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-878-0719
Mailing Address - Street 1:639 N FAIRFAX AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-1714
Mailing Address - Country:US
Mailing Address - Phone:818-878-0719
Mailing Address - Fax:323-851-3791
Practice Address - Street 1:26011 ALIZIA CANYON DR UNIT D
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-2608
Practice Address - Country:US
Practice Address - Phone:818-878-0719
Practice Address - Fax:323-851-3791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTN01091FMedicaid